David Rosenthal, Thomas Kim, and Audrey Provenzano discuss the landmark study published in Annals of Internal Medicine by Sinsky and colleagues, Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Have you ever wondered how much time you spend each month fighting with technology or filling out VNA forms? … Continue reading "Reprise – Journal Club: Sinsky et al, Allocation of Physician Time in Ambulatory Practice"
Can we solve chronic disease using a medical model? In this episode, the first in a series with speakers from the 2017 second Starfield Summit, we talked with Dr. Lloyd Michener – the principal investigator of the Practical Playbook, which facilitates the integration of primary care and public health – about why primary care clinicians need … Continue reading "Partnering Primary Care & Public Health — Lloyd Michener"
We are tremendously lucky to welcome health policy expert John McDonough as our guest this week. He has had a long and distinguished career in public service as well as a scholar and advocate. We talk about his work as a member of the MA state legislature for 13 years (discussed in his book Experiencing … Continue reading "A Career in Public Service & Drafting the ACA – John McDonough"
Today we’re joined by Lauren Taylor, a health services researcher based at Harvard Business School, where is she is earning her doctorate in health policy and management. Prior to joining HBS, Lauren co-authored The American Health Care Paradox, which has become required reading at a variety of medical and public health schools across the country. Our discussion … Continue reading "Reprise: Integration of Healthcare & Social Services with Lauren Taylor"
This week Thomas Kim, David Rosenthal, and Audrey Provenzano talk about three recently published manuscripts for a lightning round edition of Journal Club. Thomas shares a paper by Bynum et al, Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty, examining outcomes among patients primarily cared for by specialists vs primary … Continue reading "Journal Club: Lightning Round! Primary care vs Specialty care, Doorknob moments & Cost...
Primary care models integrating behavioral health services are being adopted across the country. This week, we talked with two leaders at the Lynn Community Health Center (LCHC), Dr. Mark Alexakos and Dr. Kiame Mahaniah, about their experience with integration. LCHC is unique among community health centers in that it started out as a mental health … Continue reading "Integrating Primary Care & Behavioral Health at Lynn CHC: Kiame Mahaniah & Mark Alexakos"
All of us like to think that we provide high-value care for our patients; but the truth is, just like the rest of the health care system, primary care provides a lot of low value care too – and we drive a lot of overuse. John Mafi joins us this week to talk about his … Continue reading "How do we improve the value of care delivered in primary care? with John Mafi"
Have you ever felt lonely and overwhelmed in a clinic room with a patient whose needs are far beyond your skills and ability to meet? I have, many times, and so has our guest this week, Dr. Lori Tishler. Dr. Tishler is the Vice President of Medical Affairs at Commonwealth Care Alliance, a not-for-profit organization … Continue reading "Lori Tishler of Commonwealth Care Alliance – Caring for the Most Vulnerable Patients"
This week, we are discussing an article from the Journal Women’s Health Issues, entitled: Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status, by Pooja Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, and Sindhu Srinivas. Pooja Mehta, the lead author of the study, joins us for our conversation. You can find the … Continue reading "Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status – Mehta et al"
Dr. Tom Bodenheimer is one of the world’s foremost experts in primary care re-design, having recently written about high-performing primary care clinics and the Quadruple Aim, which are articles consistently in the most-read list for the Annals of Family Medicine and among his most cited work. We focused much of our conversation on his work … Continue reading "Tom Bodenheimer – Building Blocks of High-Performing Primary Care and the Quadruple Aim"
This episode starts with a question: “what if the architectural design of an obstetric unit influenced the c-section rate in that unit?” That question occurred to obstetrician/gynecologist Neel Shah when he attended a presentation by Michael Murphy, the co-founder and executive director of Mass Design, an architectural design and research firm that focuses particularly on … Continue reading "How does architectural design impact c-section rates? Mass Design & Ariadne Labs"
Teaching health centers (THCs) are primary care residency training sites in community-based organizations, often in federally qualified health centers (FQHCs), in contrast to traditional tertiary care hospital-based training. Federal funding for the THC program, created by the ACA in 2010 and renewed through MACRA in 2015, is set to expire on September 30, 2017. THCs … Continue reading "Frederick Chen – Teaching Health Centers"
This week, we are discussing a recent article from the journal Drug and Alcohol Dependence, entitled: Association between process measures and mortality in individuals with opioid use disorders, by Katherine Watkins and colleagues: Susan Paddock, Teresa Hudson, Songthip Ounpraseuth, Amy Schrader, Kimberly Hepner, and Bradley Stein. We are also joined by a guest discussant, Gabriel … Continue reading "Journal Club – Association Between Process Measures & Mortality in Individuals with Opioid...
This week, we are joined by Dave Chokshi. Dave is the Chief Population Health Officer of OneCity Health and Senior Assistant Vice President at New York City Health + Hospitals—the largest public health care system in the U.S. He practices primary care at Bellevue Hospital and is a Clinical Associate Professor of Population Health and … Continue reading "Dave Chokshi – Population Health Management"
This week, we are joined by Danielle Ofri. Danielle is a primary care physician at Bellevue Hospital and a prolific essayist and author. We start out talking about her most recent book, What Patients Say, What Doctors Hear. We talk about communication between patients and doctors and why it can be so challenging, and how … Continue reading "Danielle Ofri – Communication Between Patients & Doctors"
Dr. Joshua Freeman is a family physician, health policy researcher, social justice activist, and writer. He publishes a widely-read blog, “Medicine and Social Justice”, and in 2015 published a book, Health, Medicine and Justice: Designing a fair and equitable healthcare system (Copernicus Healthcare press), which is available on Amazon and other sites, in both softcover … Continue reading "Joshua Freeman – Designing a Fair & Equitable Healthcare System"
This week, we bring you a journal club on the manuscript: Exploring the Patient and Staff Experience with the Process of Primary Care, which was published in Annals of Family Medicine in the July/August 2015 issue by Elizabeth J Brown, Shreya Kangovi, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter, and David Grande. If you … Continue reading "Journal Club – Exploring the Patient and Staff Experience with the Process of Primary Care"
This week, in the second of our series about physician burnout, our guests focus on solutions. Diane Shannon and Paul DeChant, both physicians, join us to talk about their recent book Preventing Physician Burnout, Curing the Chaos and Returning Joy to the Practice of Medicine. Diane and Paul talk about their experiences with burnout and … Continue reading "How to Prevent Burnout with Diane Shannon & Paul DeChant"
This week, we are joined by Colin West, professor of Medicine, Biostatistics and Medical Education at Mayo Clinic. Colin’s research focuses primarily on physician well-being, evidence based medicine and medical education. We talk today about his extensive research in the area of physician well-being and burnout. We talk about what researchers mean precisely by burnout … Continue reading "Colin West – The Evidence Behind Burnout"
Our guest this week is David Himmelstein. He is a distinguished professor of public health and health policy in the CUNY School of Public Health at Hunter College, adjunct clinical professor at Albert Einstein College of Medicine, and lecturer in medicine at Harvard Medical School. He has served as chief of the division of social … Continue reading "David Himmelstein – Blending Research & Advocacy"